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70 years on: embracing the challenge of prevention in mental health

8 January 2019

This New Year’s Day we woke to an anniversary at the Mental Health Foundation. 2019 marks 70 years since the organisation was founded, then known as the Mental Health Research Fund.

We are proud to represent 70 years of innovation in mental health. And it seems that the times have never been more welcoming to positive change. To achieve this change, we need to all join the mission that makes most sense: preventing mental health problems.

Where we began: a short history

Our original focus in 1949 was to turn research into action and to look into the different conditions in which people are born, grow, live, work and age and how this may impact their mental health. We took an approach that crossed the traditional boundaries of psychiatry and invited conversations and research across disciplines.

Later on we were among the pioneers who gave people living with mental health problems a voice in their care and the decisions affecting their lives.

More recently, we have looked into evidence-based public mental health activities. This means we have started developing solutions that work to change systems and structures and offer resources to help protect our mental health and started campaigning to create political and societal change.

Taking a holistic view of mental health, including prevention, has been at the heart of our work throughout all of these 70 years.

Why do we need to prevent mental ill health?

Based on the best data that we have, depression is the leading cause of disability worldwide and 1 in 6 of us is facing a common mental health problem every week. This is more than 10 million people in the UK. Can our overstretched NHS cope with more than 10 million people asking for clinical help because they are experiencing distress every week? The answer is simply: no.

Hence, we need to do more to prevent such problems in the first instance by taking responsibility for mental health in our workplaces, schools, homes, and those of our communities that have the least power to influence change. Mental health problems can be prevented.

How do internal and external factors impact our mental health?

Seventy years ago, our founder Derek Richter talked about the impact of issues like trauma and poverty on our mental health. We now know that we are not just victims of genes, but there is a big range of social, economic, family and emotional factors that interact with our genes. These factors can make us more or less likely to develop a mental health problem.

So beyond our genes, our mental health is fundamentally shaped by two sets of circumstances:

Firstly, the deeply personal experiences that define us (like our relationships and how we see ourselves), and secondly, the social circumstances we find ourselves in (like poverty, violence and unemployment).

If we can tackle the risk factors, we can achieve this critical mission of reducing the numbers and severity of mental health problems. We can also improve resilience to those bumps in the road that aren’t readily preventable. The determinants of mental health problems can be controlled.

The reality of how mental ill health can impact our lives

Of course, we shouldn’t underestimate the distress mental health problems can cause for people and families. Every day, hundreds of thousands of us are feeling limited and disabled by symptoms.

Every day, thousands of us are experiencing suicidal thoughts. And 16 of our fellow citizens – every single day – will reach their lowest point and take their own lives, seeking relief from what they perceived as permanent problems. But perhaps, in reality, these problems could have been managed with professional help.

We have learned so much about preventing these crisis points in the last 70 years. We have learned how a combination of clinical help, social support, and personal intervention can make the biggest difference in people’s lives, which has recently led to a reduction in the numbers of suicides in England.

Yet, we haven’t achieved the necessary policy change or implemented the right programmes to support this. Mental health crisis and suicide can be prevented.

How life events can impact our mental health

Even much earlier than these crisis points, distress tends to reach us at times when we are most vulnerable. Distress often bites during our transitions: bigger (leaving our family home for the first time) or smaller (changing a job); negative (being made redundant) or positive (becoming a parent). Or like when our physical health is challenged: by something serious (a cancer diagnosis) or something more common (not getting enough sleep).

It’s at times like these when we turn to our fundamental protective factors: our education and emotional literacy, our families and friends, our hobbies and talents.

There are several evidence-based ways – simple or more complicated – that serve the same purpose of protecting our mental health. Yet, many of us have never received this information in an accessible way (or young enough) and, as a result, were never given the chance to thrive.

While we keep working across the sector and government to correct this inequality, we can all start from our homes and communities when things get too much: be kind to yourself and compassionate to your friends and this could go a long way. Mental distress can be prevented.

We’ve made great progress in physical health…it’s time this happened in mental health

In the past 70 years, we’ve learned to ask to be vaccinated to prevent infectious diseases, we’ve got used to talking about family planning and contraception to protect our personal health, we’ve grown to consistently follow laws to wear seatbelts and not smoke indoors to prevent injuries and cancer.

We’ve made incredible progress to prevent simple or severe problems facing our physical health, and reduced the numbers of childhood deaths for children under 5 years old from over 20% to less than 5%.

Our next milestone is to make the same progress for our mental health. At a deep, fundamental level, our mental health is a mediator of our overall good health. And nothing helps our health more than structures that fully and freely allow and empower us to develop ourselves as social beings with a sense of purpose, value and belonging. Our mental health can be protected.

Prevention: possible, but challenging

Prevention is possible.

But it’s a difficult personal goal. Because often our everyday stresses consume us, and we tend to understand its value only when we notice a crisis.

And it’s a hard political sell. Because it is achieved through concentrated cross-government long-term commitments that go beyond the average political cycles.

And it’s a high social aim. Because several of the determinants allowing prevention can only be shifted through addressing issues of social justice.

And it represents a big community shift. Because we’ve mystified mental ill-health diagnoses for centuries and we’re still catching up on the stigma we’ve allowed to penetrate our way of thinking.

The challenges are many. But not disheartening. So let us look forward to the next 70 years and embrace this challenge of prevention. And when we achieve the promised progress, we will look back and see that this was our time’s greatest contribution to human flourishing. Join us in a future where we can all thrive with good mental health.

Join our movement

As Antonis says, we can prevent mental health problems and we can create a mentally healthy world. But we can't do it by ourselves. We need your help to move us forward. Please consider a donation today.